Some Health Systems Out to Beat Retailers at Clinic Game
Health Blog
WSJ’s blog on health and the business of health.
Posted by Jacob Goldstein
May 16, 2007, 4:08 pm
The debate over walk-in clinics based in retail stores, such as Wal-Mart and CVS, has largely been framed as Big Business versus the doctor or hospital around the corner.
But in some quarters, the medical establishment is piling into retail clinics as fast as the big-box retailers. In the last few days, the Health Blog has spoken with a couple of large, physician-led health groups that have opened their own retail clinics in the same towns where their doctors have offices.
“We certainly had a healthy debate over retail clinics,” Mark Briesacher, a pediatrician with Intermountain Health told us. Intermountain, which runs more than 150 hospitals and clinics spread throughout Utah and Southeastern Idaho, has opened its first five retail clinics in the past year. The clinics are in grocery stores and staffed by nurse practitioners; fees start at $35, and most patients pay out of pocket. Briesacher is on the committee that oversees the clinics.
Many family doctors and internists fear the clinics will “makes care more fragmented and makes it more difficult for an individual to have a medical home, where a physician knows a person or a family very well and treats them throughout their lifetime,” Briesacher says.
On the other hand, he says, medicine is far more complicated than it was 50 years ago. “You no longer have Doc Jones taking care of a town of 10,000 people where he delivers the babies and holds their hand at the end of life,” he says. “Doc Jones took call seven days a week, 365 days a year. That doesn’t happen anymore. Everyone shares call, everyone shares specialists that they refer to.”
In the end, Intermountain decided it was worthwhile to try retail clinics as a more convenient alternative for those seeking treatment for simple problems such as sore throats, and as an option for the uninsured who might not otherwise seek any care at all.
Back East, Dean Lin runs the retail-clinics group for Geisinger Health System, which employs more than 600 doctors and runs several major medical centers in central Pennsylvania. He cites similar reasons for getting into retail clinics, and added another: “MinuteClinic [owned by CVS] and Wal-Mart are building these clinics. We thought if we didn’t do it someone else would.” The group has opened two clinics so far, and plans to have five within the next few months. Lin says Geisinger hasn’t decided how many clinics it plans to open beyond that. But, he says, “Hundreds is not out of the question.”
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I think a clinic in Walmart would be useful as outreach to the community to check blood pressures, blood sugar, and weight especialy if that data got reported back to the primary care doctor. That is what primary health care should focus on. But that is the furthest thing from the Minute Clinic business model where the focus is to promote the drugs the CVS pharmacy is selling. A sore throat is a wasted office visit most of the time. Afterall, there is no cure for the common viral cold. I agree that a medical home where care is coordinated rather fragmented should be our goal and I believe there is evidence that the fewer practitioners involved in a patient’s care the lower the overall cost. I do not fear the Minute Clinics. But the first time I get a phone call from a patient at 2AM in the middle of the night, because they are having an adverse reaction to something they got at Minute Clinic, I will probably be a little angry. Minute Clinic got paid to prescribe the drug. I do not get paid to get woken up in the middle of the night.
Comment by Primary Care Physician - May 16, 2007 at 10:48 pm
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